- AmeriHealth Caritas (Orlando, FL)
- ** Medical Director , UM Review,...policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical ... to practice in any state licensed in as a medical director . Additional state licensure required in...within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your career starts now. We… more
- CVS Health (Springfield, IL)
- …you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director , Medical Affairs. These projects can ... Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM...special clinical investigations and research as requested by the Senior Medical Director , Medical… more
- ChenMed (Louisville, KY)
- …P&L leader for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director ... conjunction with the transitional care team; hospital, SNF, post-acute, UM , and home-based services for the division. + Assists... director training prior to promotion to Senior Medical Director , as part… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. Job Purpose and Summary: The LTSS/SAI National Senior Medical Director , reporting to a Regional CMO of ... LTSS line of business including but not limited to UM , Quality, care management, and network growth as listed...team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community,...* Be able to effectively communicate these finding to Senior Management and staff at all levels.* Develop and… more
- The Cigna Group (Philadelphia, PA)
- **OVERVIEW:** The Chief Pharmacy Officer ( Senior Director ) oversees and directs the creation, adoption and evaluation of clinical pharmacy programs, product and ... Health Plan book of business. + Partners with the Health Plan National Medical Officer for Pharmacy to develop and deploy clinical affordability solutions for drugs… more
- Magellan Health Services (Dallas, TX)
- …clinical quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...various committees or project teams as directed by the senior medical director or vice-president.… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
- AdventHealth (Maitland, FL)
- …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of utilization,… more
- University of Miami (Coral Gables, FL)
- …law school stakeholders, including members of decanal advisory and oversight committees, UM senior administrators, trustees, donors, and other stakeholders. Bar ... the Dean of the School of Law. RESPONSIBILITIES: The Director will lead the program, and will work closely...one of the nation's top research universities and academic medical centers in the nation. The University comprises 12… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- … leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... + Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key...skills and understanding of CMS Part C guidance including UM operational procedures, and CMS guidance including coverage and… more
- University of Michigan (Ann Arbor, MI)
- …society. **Responsibilities + Provide administrative and calendar management support to the Senior Associate Chair for Research; Executive Director , Pain & ... Administrative Assistant Senior Healthcare Apply Now **How to Apply** A...with writing a variety of correspondence including faculty and medical school recommendation letters and tracking due dates. +… more
- University of Miami (Coral Gables, FL)
- …related experience. Bachelor's degree preferred. Position requires significant experience with UM purchasing systems. The Senior Program Coordinator should have ... of Student Affairs, has a great opportunity for a Senior Program Coordinator to work at the Coral Gables...budget of the Student Bar Association, and assist the Director of Programs in managing the budget for the… more
- The Cigna Group (Bloomfield, CT)
- …partners with Coverage Policy Unit (CPU) medical policy team, manager, CPU Medical Director , clinical subject matter experts, and external vendors to meet ... Participates in National Clinical Updates and Pearls (CUPS) Calls, with UM RNs and Medical Directors, responding to questions and providing clarification on new… more
- Highmark Health (Columbus, OH)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate,...+ Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... utilization of healthcare services by reviewing patient cases for medical necessity, appropriateness, and efficiency of Munson Healthcare's services. This… more
- University of Michigan (Ann Arbor, MI)
- Medical Biller/Patient Account Specialist Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the ... to this position. **Summary** **Department Summary** The University of Michigan ( UM ) University Health Service (UHS), is an ambulatory, multispecialty health clinic… more
- University of Miami (Miami, FL)
- …is currently seeking a full time Sr. Manager, Programs. The Senior Manager, Programs oversees the day-to-day administrative management of assigned program(s) ... to the University faculty and staff and other key stakeholders. Furthermore, the Senior Manager, Programs serves as the liaison to leadership, faculty, students, and… more
- University of Michigan (Ann Arbor, MI)
- …of nursing and as indicated, assigned clinical assistive staff, with feedback from the senior nursing director , medical faculty, peer groups, and ACU ... services and transition care towards the mission/goals of Michigan Medicine. To assist the Senior Nursing Director in planning and management of the patient care… more
- University of Miami (Miami, FL)
- …incoming faculty. + Assisting with clinic closure + completes entire onboarding checklist for UM , Jackson, VA. + Work along with Director of Operations, on human ... + Advances strategic financial plan and makes recommendations to senior management on how to best execute the department's...guidelines. + Ensuring proper equipment is provided; computer, phone, UM access. + Ensuring communications are sent out to… more
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